| NPI | 1255371126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX H8442) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX H8442) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2008-10-27 |